ANEMIA IN PATIENTS WITH ANKYLOSING SPONDYLITIS, PECULIARITIES HEMOPOIESIS AND FERROKINETICS IN DEPENDING FROM PATHOGENETIC TYPE

Shevchuk O.V. , Zviahina O.V.

Summary. Аim. To study the frequency and spectrum of anemia in patients with ankylosing spondylitis (AS), to characterize the features of their hematopoiesis and ferrokinetics, as well as to determine the relationship with sex, age and duration of the disease. Object and methods. A total of 118 patients were diagnosed with AS in accordance with the modified New York criteria. The control group consisted of 26 healthy individuals, representative of age and gender. Anemia was exhibited with a decrease in hemoglobin level of less than 120 g/l. To assess hematopoiesis and ferokinetics, hemoglobin, erythrocytes, MCV, serum iron, total iron binding capacity of serum, serum ferritin, transferrin saturation coefficient, and soluble transferrin receptors were measured. Results. Anemia in patients with AS occurs in 28.8% of cases, and in 10 (11.9%) latent iron deficiency is recorded. The spectrum of anemia is represented by ACD (44.1%), ACD with iron deficiency (29.4%) and IDA (23.5%). The cytometric characteristics of IDA in 75% of patients are microcytic, while ACD and ACD with iron deficiency of 86.8% and 70%, respectively, are normocytic. Changes in hematopoiesis and ferokinetics in patients with AS with IDA were characterized by high levels of red blood cells, TIBC and sTfR, microcytosis and low levels of serum iron, CST and ferritin. In patients with ACD, moderate changes in iron metabolism were observed, patients with ACD with concomitant iron deficiency occupied intermediate positions by these indicators. Discussion. Our findings were comparable to those of other researchers who indicate that the frequency of anemia in different ethnic groups of patients with AS varies within 18.5–45.8% (Braun J. et al., 2009; Kim K.J., Cho C.S., 2012; Щербаков Г.И. и соавт., 2016; Bulut Y. et al., 2017). Conclusions. Anemia in patients with AS was found in 28.8% of cases. Anemic syndrome was represented by ACD, ACD with iron deficiency and IDA. IDA was predominantly microcytic in nature, and ACD and ACD with iron deficiency normocytic. The direction of changes in hematopoiesis and ferokinetics in patients with AS depends on the type of anemia.